Aetiological approach of female reproductive physiology in lactational amenorrhoea.

The duration of postpartum amenorrhea and return of ovulation varies on an individual and population basis. In 1980, in Senegal, the relationship of chronic malnutrition and female fertility was investigated for 2 years. The stability of the female body regarding weight and arm circumference despite a heavy annual workload was a surprising finding. The mean female body mass index was higher for lactating women in amenorrhea than required for restoring menstruation in European women. The mean duration of postpartum amenorrhea was 18.2 +or- .6 months. The difference between those who resumed menstruation (20.9 +or- .9 months) and who still had amenorrhea (25.4 +or- 2.2 months) was significant. The duration of breast feeding determined the duration of amenorrhea. Studies have found a link between ovarian dysfunction and women in harsh third world environments and sportswomen under intensive training with both showing irregular menstruation and amenorrhea. Long duration of cycles in New Guinean women, high amount of anovulation in Zairian forest women, and suppression of testosterone and estradiol levels in hunter-gatherers were found. In affluent Europeans and urbanized women in developing countries postpartum amenorrhea dropped drastically. Long distance runners are often vegetarians with low calorie consumption and with a high degree of menstrual trouble owing to low body fat and weight-for-height. The role of beta-endorphins in the hypothalamic blockade of the gonadotropin releasing hormone pulse generator and high stress or physical training is proven. The functioning of the hypothalamo-pituitary-ovarian axis can be hurt by intensive training. Short-term fasting also suppressed the pulsatile luteinizing hormone and testosterone secretion. The protocol and methodology of an etiological study is outlined regarding the factors of this hypothesis on amenorrhea.